Miguel Ismael Bustamante, DDS is a
Dentist - General Practice based in Bolinas, California. Miguel Ismael Bustamante is licensed to practice in California (license number 034821) and his current practice location is
24 Wharf Road, Bolinas, California. He can be reached at his office (for appointments etc.) via phone at
(415) 868-0911.
NPI number for Miguel Ismael Bustamante is 1194160341 and his current mailing address is Po Box 975, Bolinas, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1194160341.
Healthcare Provider's Profile
| Full Name | Miguel Ismael Bustamante |
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| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 24 Wharf Road, Bolinas, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1194160341
- Provider Enumeration Date: 05/01/2013
- Last Update Date: 05/01/2013
Medical Identifiers
Medical identifiers for Miguel Ismael Bustamante such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194160341 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 034821 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miguel Ismael Bustamante is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Miguel Ismael Bustamante, DDS
Po Box 975,
Bolinas, CA 94924-0975
Ph: (415) 868-0911 | Miguel Ismael Bustamante, DDS
24 Wharf Road,
Bolinas, CA 94924
Ph: (415) 868-0911 |
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